Dentistry Section
DOI: 10.7860/JCDR/2014/8339.4554
Original Article
Comparison of Intrusion Effects on Maxillary Incisors Among Mini Implant Anchorage, J-Hook Headgear and Utility Arch
Ravindra Kumar Jain1, Sridhar Prem Kumar2, W.S. Manjula3
ABSTRACT Background: Intrusion of maxillary incisors is one of the most important and difficult tooth movements to achieve as a part of orthodontic therapy. A variety of techniques were used in the past to intrude the maxillary incisors before the emergence of mini implants in Orthodontics. Mini implants are temporary anchorage devices used to produce various tooth movements. The research was carried out to evaluate and compare the efficiency of producing intrusion of maxillary incisors using mini implants, utility arch and j- hook headgear. Materials and Methods: The study was conducted on 30 subjects divided into 3 Groups equally. Group 1- mini implant anchorage, Group 2 - j- hooks headgear and Group 3- utility arch were used for intrusion of the maxillary incisors. Conventional
lateral cephalograms were taken before treatment and at the end of intrusion. Five cephalometric parameters were used to measure the amount of intrusion attained in each Group. Intra Group comparisons were done using student t-test and inter Group comparisons were done using ANOVA The duration of intrusion was four months in all the three Groups. Results: In Group 1 the mean average intrusion attained was 2.1 mm, the mean average intrusion attained in Group 2 was 0.7 mm, and the mean average intrusion achieved in Group 3 was 1.4 mm with a side effect of 0.75 mm of molar extrusion. Conclusion: Although, both mini implants and utility arch can be used to attain significant amounts of incisor intrusion but using mini implants will produce true intrusion without any other side effects.
Keywords: Incisor intrusion, J-hook headgear, Mini implants, Utility arch
INTRODUCTION Deep bite is a clinical problem not to be seen in terms of millimeters but to be seen in light of future changes in the aesthetics, function and health of the dentition [1]. Possible complications of deep bite include, temporomandibular joint disorders, unacceptable facial aesthetics, attrition of incisors, spacing of maxillary incisors, clenching of teeth, jaw stiffness, head ache and ringing in ears [2]. Methods to correct deep bite include extrusion of posterior teeth, relative intrusion of incisors and true intrusion of incisors [3,4]. True intrusion of incisors is primarily indicated in deep bite cases with a large vertical dimension, patients with excessive incision stomion distance and a large inter labial gap. Advantages of true intrusion of anterior teeth include achievement of lip competency, reduced incisal exposure without any increase in lower anterior facial height [3]. Appliances for incisor intrusion include utility arch by Ricketts, Burstone intrusion arch, Connecticut intrusion arch, and J-hook
[Table/Fig-1]: Mini implant intrusion
headgear. The major disadvantages with these appliances include extrusion and tipping of posterior teeth, complex wire bending and patient co-operation. Mini screws have been successfully used as temporary anchorage devices for producing various tooth movements [5]. Recently, Mini screws as effective temporary anchorage devices have occupied a central role in a typical orthodontic setup, since anchorage control and patient cooperation are very critical. Many authors have documented the use of mini implants for intruding incisors and have reported statistically significant amounts of incisor intrusion with Minimplants [6-9]. This study aims at evaluating and comparing the intrusion effects on maxillary incisors by mini implant anchorage, j-hook headgear and utility arch.
MATERIALS AND METHODS The study was conducted on 30 patients (19 females and 11 males) and the average age range was 16-22 years. The study was
[Table/Fig-2]: J-hook headgear
Journal of Clinical and Diagnostic Research. 2014 Jul, Vol-8(7): ZC21-ZC24
[Table/Fig-3]: Utility arch
21
Ravindra Kumar Jain et al., Comparison of Intrusion Effects on Maxillary Incisors Among Mini Implant Anchorage, J-Hook Headgear and Utility Arch Groups Treatment
Group 1
Over jet - Pre
Group 2
OVERJET_DIF
Group 3
Mean
SD
Mean
SD
Mean
SD
8.58
1.20
8.00
2.26
7.75
2.14
Between Groups
Between Groups
.66
7.20
2.17
7.33
1.51
Over bite - Pre
6.25
1.08
6.20
.84
7.08
1.96
Within Groups
Over bite - Post
3.92
.92
5.40
.55
5.08
2.01
Total
PP U1 - Pre
31.33
2.58
29.80
2.14
30.25
2.54
PP U1 - Post
29.25
2.52
29.70
2.28
28.92
2.87
Within Groups
PP U6 - Pre
27.17
2.80
24.90
1.47
26.33
2.23
Total
PP U6 - Post
27.00
3.02
25.10
1.43
27.08
2.13
UL U1 - Pre
7.33
3.09
8.90
1.29
6.08
2.06
Within Groups
UL U1 - Post
5.42
2.76
8.10
.74
4.67
1.60
Total
Treatment
T
Group 2 Sig. (2-tailed)
T
PPU1_DIF
PPU6_DIF
ULU1_DIF
T
4.784
.026*
Between Groups
33.778
.000**
Between Groups
10.697
.002*
Between Groups
12.189
.001*
Total
Sig (2-tailed)
Note: * denotes- p
DOI: 10.7860/JCDR/2014/8339.4554
Original Article
Comparison of Intrusion Effects on Maxillary Incisors Among Mini Implant Anchorage, J-Hook Headgear and Utility Arch
Ravindra Kumar Jain1, Sridhar Prem Kumar2, W.S. Manjula3
ABSTRACT Background: Intrusion of maxillary incisors is one of the most important and difficult tooth movements to achieve as a part of orthodontic therapy. A variety of techniques were used in the past to intrude the maxillary incisors before the emergence of mini implants in Orthodontics. Mini implants are temporary anchorage devices used to produce various tooth movements. The research was carried out to evaluate and compare the efficiency of producing intrusion of maxillary incisors using mini implants, utility arch and j- hook headgear. Materials and Methods: The study was conducted on 30 subjects divided into 3 Groups equally. Group 1- mini implant anchorage, Group 2 - j- hooks headgear and Group 3- utility arch were used for intrusion of the maxillary incisors. Conventional
lateral cephalograms were taken before treatment and at the end of intrusion. Five cephalometric parameters were used to measure the amount of intrusion attained in each Group. Intra Group comparisons were done using student t-test and inter Group comparisons were done using ANOVA The duration of intrusion was four months in all the three Groups. Results: In Group 1 the mean average intrusion attained was 2.1 mm, the mean average intrusion attained in Group 2 was 0.7 mm, and the mean average intrusion achieved in Group 3 was 1.4 mm with a side effect of 0.75 mm of molar extrusion. Conclusion: Although, both mini implants and utility arch can be used to attain significant amounts of incisor intrusion but using mini implants will produce true intrusion without any other side effects.
Keywords: Incisor intrusion, J-hook headgear, Mini implants, Utility arch
INTRODUCTION Deep bite is a clinical problem not to be seen in terms of millimeters but to be seen in light of future changes in the aesthetics, function and health of the dentition [1]. Possible complications of deep bite include, temporomandibular joint disorders, unacceptable facial aesthetics, attrition of incisors, spacing of maxillary incisors, clenching of teeth, jaw stiffness, head ache and ringing in ears [2]. Methods to correct deep bite include extrusion of posterior teeth, relative intrusion of incisors and true intrusion of incisors [3,4]. True intrusion of incisors is primarily indicated in deep bite cases with a large vertical dimension, patients with excessive incision stomion distance and a large inter labial gap. Advantages of true intrusion of anterior teeth include achievement of lip competency, reduced incisal exposure without any increase in lower anterior facial height [3]. Appliances for incisor intrusion include utility arch by Ricketts, Burstone intrusion arch, Connecticut intrusion arch, and J-hook
[Table/Fig-1]: Mini implant intrusion
headgear. The major disadvantages with these appliances include extrusion and tipping of posterior teeth, complex wire bending and patient co-operation. Mini screws have been successfully used as temporary anchorage devices for producing various tooth movements [5]. Recently, Mini screws as effective temporary anchorage devices have occupied a central role in a typical orthodontic setup, since anchorage control and patient cooperation are very critical. Many authors have documented the use of mini implants for intruding incisors and have reported statistically significant amounts of incisor intrusion with Minimplants [6-9]. This study aims at evaluating and comparing the intrusion effects on maxillary incisors by mini implant anchorage, j-hook headgear and utility arch.
MATERIALS AND METHODS The study was conducted on 30 patients (19 females and 11 males) and the average age range was 16-22 years. The study was
[Table/Fig-2]: J-hook headgear
Journal of Clinical and Diagnostic Research. 2014 Jul, Vol-8(7): ZC21-ZC24
[Table/Fig-3]: Utility arch
21
Ravindra Kumar Jain et al., Comparison of Intrusion Effects on Maxillary Incisors Among Mini Implant Anchorage, J-Hook Headgear and Utility Arch Groups Treatment
Group 1
Over jet - Pre
Group 2
OVERJET_DIF
Group 3
Mean
SD
Mean
SD
Mean
SD
8.58
1.20
8.00
2.26
7.75
2.14
Between Groups
Between Groups
.66
7.20
2.17
7.33
1.51
Over bite - Pre
6.25
1.08
6.20
.84
7.08
1.96
Within Groups
Over bite - Post
3.92
.92
5.40
.55
5.08
2.01
Total
PP U1 - Pre
31.33
2.58
29.80
2.14
30.25
2.54
PP U1 - Post
29.25
2.52
29.70
2.28
28.92
2.87
Within Groups
PP U6 - Pre
27.17
2.80
24.90
1.47
26.33
2.23
Total
PP U6 - Post
27.00
3.02
25.10
1.43
27.08
2.13
UL U1 - Pre
7.33
3.09
8.90
1.29
6.08
2.06
Within Groups
UL U1 - Post
5.42
2.76
8.10
.74
4.67
1.60
Total
Treatment
T
Group 2 Sig. (2-tailed)
T
PPU1_DIF
PPU6_DIF
ULU1_DIF
T
4.784
.026*
Between Groups
33.778
.000**
Between Groups
10.697
.002*
Between Groups
12.189
.001*
Total
Sig (2-tailed)
Note: * denotes- p
